We need more from Lorraine O’Connor, and less from Harney and Drumm September 21, 2007

On Thursday a young nurse from Cork brought the crowd at the annual conference of the Irish Nurses Organisation in Killarney to their feet with an impassioned cry for people to ‘wake up’ to what is going on in our health service. Her name is Lorraine O’Connor. She was one of a number of speakers to point out the damage the cutbacks the HSE is implementing to save between 245 and 250 million Euros is causing.

Liam Doran pointed out that nurses due to go to London to receive training in neo natal and intensive care provision from top medical practitioners were unable to go because the hospital was not allowed to hire replacements for them during their absence, despite the massive shortage of nurses with those specialised skills. The London-based training programme was put in place following the death of a two-year-old child in Crumlin Hospital because of a lack of intensive care nurses.

Joan Tobin, from Waterford, said there had been cutbacks in the numbers of porters, security staff, laundry service and up to 30 clerical staff. Some of our more simplistic minded right-wing commentators might argue that these cutbacks are worth it to save ‘frontline’ staff, part of gutting what Fine Gael today called the ‘bloated bureaucracy’ of the Health Service.

Let’s throw some facts at this, courtesy of IMPACT. The Government’s 2003 Brennan Report on health service management found that 6% of health service staff work in backroom administrative or management roles. Drumm himself admitted not too long ago that ‘back of house’ admin staff accounts for 3,300 (About 3%) of health service staff. The reality is that these people are what allows us to have frontline staff in the first place. Without them, nurses would be spending their spare time providing their own legal services, doing patient laundry, running their own Human Resources and in-service training, IT services, administration and filing.

But even frontline staff are under threat. One of the places that will be ‘unaffected’ by the budget cuts is Sligo. Sligo General Hospital is to lose 30 agency nurses, four locum consultants (Specialising in orthopaedics, obstetrics and gynaecology, breast disease and ear, nose and throat problems) and a number of housekeeping staff. The INO, who are advising members not to co-operate with the proposal, say that the loss of 34 frontline medical staff as well as housekeeping will lead to bed closures, reduced services and more suffering for patients. The IMO says it will lead to longer waiting lists and cancelled clinical appointments. Harney and Drumm say it will have no, repeat no, effect on patient care.

The nurses strike, the HSE told us with that feigned concern for patients its management teams do so well, would be devastating for nurses. It was also a breach of the Social Partnership agreement, but as the National Implementation Body has pointed out this evening, the ban on recruitment and personnel cutbacks the HSE has announced were introduced without consultation and breach the partnership agreement. One wonders if the boot will be put into the bed closers of the HSE to the extent it was put into the nurses.

But sure if the beds are closed, is there not a hotel nearby they could be put up in? There was some media attention on the revelation that lack of bedspace was forcing the Rotunda to put patients in the Jurys Hotel on Christchurch. This is a phenomenon that Drumm described as ‘forward thinking’ and ‘the way forward for the Irish health system before going on to say that ‘our whole plan in building new hospitals will be to have hotels on the sites.’

Drumm’s explanation for this is that a patient staying in a hospital costs ‘four and five times’ more than it costs for a patient to be put up in a hotel. I suspect, though no expert on medical budgeting I be, that this may have something to do with the provision of a number of highly trained medical professionals and technologically advanced medical equipment common to some Irish hospitals. If I am unwell enough to be in a hospital, or at risk of worsening from my ‘low-risk’ status, I would prefer, if it was all the same to Prof Drumm, that my chief carer was not the Jurys bellhop using a green box first aid kit.

So, what’s the explanation for all this lunacy? The cutbacks in frontline staff. The cutbacks in their administrative support. The number of top HSE Managers increasing from six in 2001 to a staggering 526 today. The suggestion that we should be putting patients in the local Jurys. Well, it’s simple enough really.

According to Minister Harney, “Each hospital manager has to plan the running of their hospital based on that budget, as every organisation has to do. The health service is not different to any other organisation.”

Two points. Change the word ‘organisation’ to ‘business’ and reread the sentence. Hospitals must conduct their operation based not on assessment of need or patient requirements (Perish the thoughts) but, like any other ‘business’, on the budget they are allocated.

Secondly, it is stunning that the Minister for Health and Children says that the health service is not different to any other organisation. It is fundamentally different, or supposed to be. It is the primary caregiver to millions of Irish people. It is there when we are born, it is there when we die. It is a key component of the contract between the citizen and the state. It is arguably the most important service provided by the state and access to healthcare is a basic, fundamental human right.

Worth noting as well that when it comes to increased bonuses for Drumm, more top managers and, as I noted previously, more bonuses for top managers, the money can always be found.

Finally, and not too far off topic, a report in today’s Irish Times (Sub required) pointing out that the inequalities in our health service begin before birth. With Harney and Drumm, they will continue, even be exacerbated, throughout their lives.

Our health service needs more from the likes of Lorraine O’Connor, and a lot less from the wacky world of Drumm and Harney.

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Frank, while the hiring restrictions are evidently not well thought out, idolising the INO’s stance is lending credibility to their own particular vested interests. Health Care reform needs less of Harney and privatisation in our health service but it also needs less of the health unions shouting “Our Jobs, Our Jobs, Our Jobs!”. How can you now justify the Nurses strike last May if you bemoan the cutbacks? Surely, their pay-rise would have had the same consequences as these cutbacks – the HSE budget would still overrun. Increased taxation is the obvious solution but it seems the discourse in Ireland is solidly centred around opposition to this, unfortunately.

If you agree with the general thesis of the Hanley Report, that we should have a few major regional hospitals and minor, local hospitals as the best way to provide front-line services, would you support the INO as much as you do here when the likes of Sligo Hospital are downgraded to make way for a major hospital in the West, in say, Galway? They are guaranteed to jump on the local opposition bandwagon to such moves, under a false pretence of what is best for patients.

In this current case, both the pretence and the INO’s interests are one and the same and hence politically convenient for their own interests. But when the INO’s interests and the actual needs of the public are at odds, who will you back? This is a crucial question the left must answer if we are ever to achieve a proper, equitable and effective health system in this country.

On Thursday, Lorraine O’Connor highlights the precarious nature of the Health Service.
On Friday there are indignant complaints that Dublin Airport cannot offer enough slots for the 100+ private jets that want to go to Paris for the rugby match.